Evidence map›Paper›PMID 42711633›Full record

ArticleClinical rheumatology2026

Sex and age influence the association between insulin resistance and all-cause mortality in rheumatoid arthritis patients.

Jiahui Yan, Yifei Li, Youpeng Su, Xin Ba, Weiji Lin, Tingting Li, Ruiyuan Zhang, Pan Shen, Yao Huang, Ying Huang and 8 more

Abstract read
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In one paragraph

Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Jiahui YanDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yifei LiDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Youpeng SuDepartment of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xin BaDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Weiji LinDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tingting LiDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ruiyuan ZhangDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Pan ShenInstitute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yao HuangDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ying HuangDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Kai QinDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hua HuangDepartment of Rheumatology, Jingmen People's Hospital, Jingmen, Hubei, China.
Liang ZouDepartment of Rheumatology, Jingmen People's Hospital, Jingmen, Hubei, China.
Yafei LiuDepartment of Nephrology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Yu WangDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhe ChenDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Liang HanInstitute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. hanliangric@gmail.com.
Shenghao TuDepartment of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. shtu@tjh.tjmu.edu.cn.

Funding

Jingmen Science and Technology Bureau 2022YFZD014National Natural Science Foundation of China 82074267National Natural Science Foundation of China 82104639National Natural Science Foundation of China 82174185National Natural Science Foundation of China 82204871National Natural Science Foundation of China 82204872
6 · The paper itself

Abstract

objectivesTo investigate the association between insulin resistance (IR) and all-cause mortality among adults with rheumatoid arthritis (RA).

methodsIn this cohort study, we included 1,427 adults with self-reported RA from the National Health and Nutrition Examination Survey (NHANES) 1999-2010 and 2015-2018. IR was assessed using the homeostatic model assessment of insulin resistance (HOMA-IR). Survey-weighted multivariable Cox proportional hazards models were used to evaluate the association between HOMA-IR and all-cause mortality.

resultsDuring a mean follow-up of 9.7 years, 491 deaths occurred. Compared with participants in the lowest tertile of HOMA-IR, the multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were 0.633 (0.466-0.860) and 0.626 (0.463-0.847) for the second and third tertiles, respectively. Each 1-standard deviation increase in HOMA-IR was associated with a 14.5% lower risk of all-cause mortality (HR 0.855, 95% CI 0.734-0.995). The association varied by age and sex. Stratified analyses suggested that higher HOMA-IR was associated with increased mortality risk in men aged < 70 years and women aged < 50 years, whereas inverse associations were observed in men aged ≥ 70 years and women aged ≥ 50 years.

conclusionsThe association between HOMA-IR and all-cause mortality among adults with RA differed according to age and sex. Although higher HOMA-IR was inversely associated with mortality overall, subgroup-specific associations were heterogeneous and should not be interpreted as evidence of a protective effect of IR. Further studies are needed to clarify the mechanisms underlying these age- and sex-related differences. Keypoints • This study provides the first nationally representative evidence on the association between HOMA-IR and all-cause mortality among U.S. adults reporting rheumatoid arthritis. • HOMA-IR showed an approximately L-shaped association with all-cause mortality. • The association differed by age and sex, with higher mortality risk in younger subgroups and inverse associations in older subgroups. • The findings remained consistent across multiple sensitivity analyses addressing medication use, C-reactive protein (CRP) assessment, missing data, and potential reverse causation.

Indexed as

Cohort studyHomeostatic model assessment of IR (HOMA-IR)Insulin resistanceMortality riskNHANESRheumatoid arthritis (RA)

Identifiers

PMID42711633

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.